• Journal of Korean Foot and Ankle Society
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• v.23 no.1
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• pp.18-23
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• 2019

Purpose: This study compared and analyzed the risk factors that affect a wound healing group and healing failure group. Materials and Methods: From 2010 to 2018, 39 patients who had suffered a single toe amputation were evaluated retrospectively. The patients were divided into two groups (wound healing group and healing failure group - within at least 3 months following the amputation). Regarding the possible risk factors, age, gender, Wagner and Brodsky classifications, duration of diabetes mellitus, whether the patient had peripheral arterial occlusive disease (PAOD) or cardiovascular disease, body mass index, HbA1c, total cholesterol, estimated glomerular filtration rate (eGFR), blood urea nitrogen (BUN), smoking, and alcohol were investigated. Results: The mean duration of diabetes mellitus was 140 months in the healing group and 227 months in the healing failure group, and the duration of diabetes was significantly longer in the failure group (p=0.009). A significant difference in eGFR was observed between the two groups ($59.17mL/min/1.73m^2$ in the healing group and $31.1mL/min/1.73m^2$ in the failure group) (p=0.022). Sixteen patients with PAOD were found, all 10 patients in the healing failure group were PAOD patients. Conclusion: To reduce the additional complications in single toe amputation patients, the underlying disease and appropriate treatment are the most important factors. In addition, a more proximal level of amputation also should be considered in cases of patients with PAOD, high BUN and low eGFR, and patients with long-term diabetes.

• Journal of Pharmacopuncture
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• v.22 no.2
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• pp.109-114
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• 2019

Objectives: Oxidative stress plays a central role in diabetes-induced complications. In the present study, the protevtive effect of Artemisia turanica (A. turanica) was evaluated against diabetes-induced liver oxidative stress and dysfunction. Methods: Fifty male Wistar rats were randomly divided into five groups: control, diabetic, diabetic + metformin, diabetic + A. turanica extract, and diabetic + A. turanica extract + metformin. Experimental diabetes was induced by a single-dose (55 mg/kg, intraperitoneally (ip)) injection of streptozotocin (STZ). Metformin (300 mg/kg) and A. turanica extract (70 mg/kg) were orally administrated three days after STZ injection for four weeks. The levels of malondialdehyde (MDA), total thiol content and superoxide dismutase (SOD) and catalase activities were measured in the liver tissue. Serum glucose concentration, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activities were also determined. Results: In the diabetic group, serum glucose concentration, serum AST and ALT activities and liver MDA level were significantly higher while tissue total thiol content as well as catalase and SOD activities were lower, compared to the control group. Serum glucose in diabetic rats treated with metformin + A. turanica extract showed a significant decrease compared with the diabetic group. In all the A. turanica extract and metformin treated groups, serum ALT, tissue MDA level, total thiol content and SOD activity significantly improved compared with the diabetic rats. However, treatment of the diabetic rats only with metformin could not significantly change the activities of catalase and AST compared with the diabetic group. Conclusion: These findings suggested that A. turanica extract had a therapeutic effect on liver dysfuncyion and oxidative stress induced by diabetes, that may be probably due to its antioxidant and antiinflammatory effects.

• Archives of Plastic Surgery
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• v.45 no.4
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• pp.379-383
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• 2018

Septoplasty/septorhinoplasty is a common ear, nose and throat procedure offered for those patients with deviated septum who are suffering from nasal obstruction and functional or cosmetic problems. Although it is a basic and simple procedure, it could lead to catastrophic complications including major skull base injuries which result in cerebrospinal fluid (CSF) leaks. We describe two different cases of traumatic CSF leaks following septoplasty/septorhinoplasty at two different sites. The first patient suffered a CSF leak following septoplasty and presented to Alexandria University Hospital. The leak was still active at presentation and identified as coming from a defect in the roof of the sphenoid sinus and was repaired surgically. The second patient presented 4 days after her cosmetic septorhinoplasty with a CSF leak and significant pneumocephalus. She was managed conservatively. Understanding the anatomical variations of the paranasal sinuses and implementing proper surgical techniques are crucial in preventing intracranial complications when performing either septoplasty or septorhinoplasty. A good quality computed tomography of the nose and paranasal sinuses is a valuable investigation to avoid major complications especially CSF leaks following either procedure.

• The Journal of Korean Physical Therapy
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• v.23 no.6
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• pp.61-69
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• 2011

Purpose: This study investigated the changes in body composition and serum lipid composition in obese women that were caused by a 12-week circuit exercise regime including both field and aquatic activities. Methods: Subjects comprised a total of 36 women who had a BMI of more than $25kg/m^2$. The simple obesity group (n=17) had no current or past record of medical complications, whereas the group with complications (n=19) also suffered from hypertension and/or diabetes. The circuit exercise program consisted of 12 weeks of 60%HRmax exercise sessions, five days a week. Results: While changes in every variable of body composition were significant, there was no statistically significant difference in the changes in serum lipid composition variables. With the exception of BMI, the correlation between the simple/complicated groups and exercising was statistically insignificant. Conclusion: These findings suggest that while a complex circuit weight exercise program that includes aquatic exercises significantly and positively alters obese patients' body composition it does not create statistically significant changes in their serum lipid composition. It can still be concluded, however, that increasing the duration of the exercise program would be effective to influence this. Moreover, personalized exercise programs that fit the needs of the individual participants seem necessary, given that the effect of exercise on body composition and serum lipid composition was greater in patients with simple obesity than in those with complications.

• Food Science and Preservation
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• v.24 no.4
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• pp.536-541
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• 2017

Hyperglycemia found in diabetes mellitus causes several physiological abnormalities including the formation of advanced glycation end products (AGEs) and oxidative stress. Accumulation of AGEs and elevation of oxidative stress plays major roles in the development of diabetic complications. Adiponectin secreted from adipocytes is known to improve insulin sensitivity and blood glucose level. Curcumin (CCM), a bioactive component of turmeric, has been reported as a potent antioxidant. Present work aimed to elucidate the roles of CCM in high glucose-induced protein glycation and intracellular events in mature adipocytes. The results demonstrated that CCM inhibited the formation of fluorescent AGEs by approximated 52% at 3 weeks of bovine serum albumin (BSA) glycation with glucose. Correspondingly, CCM decreased the levels of fructosamine and ${\alpha}-dicarbonyl$ compounds during BSA glycation with glucose. These data suggested that CCM might be a new promising anti-glycation agent. Also, CCM reduced high glucose-induced oxidative stress in a dose dependent manner, whereas CCM treatment time-dependently elevated the expression of adiponectin gene in 3T3-L1 adipocytes. The findings from this study suggested the possibility of therapeutic use of CCM for the prevention of diabetic complications and obesity-related diseases.

• Archives of Plastic Surgery
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• v.45 no.5
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• pp.418-424
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• 2018

Background Complication rates after flap coverage for pressure ulcers have been high historically. These patients have multiple risk factors associated with poor wound healing and complications including marginal nutritional status, prolonged immobilization, and a high comorbidities index. This study utilizes the National Surgical Quality Improvement Program (NSQIP) to examine perioperative outcomes of flap coverage for pressure ulcers. Methods Data from the NSQIP database (2005-2015) for patient undergoing flap coverage for pressure ulcers was identified. Demographic, perioperative information, and complications were reviewed. One-way analysis of variance and Pearson chi-square were used to assess differences for continuous variables and nominal variables, respectively. Multivariate logistic regression was performed to identify independent risk factors for complications. Results There were 755 cases identified: 365 (48.3%) sacral ulcers, 321 (42.5%) ischial ulcers, and 69 (9.1%) trochanteric ulcers. Most patients were older male, with some degree of dependency, neurosensory impairment, high functional comorbidities score, and American Society of Anesthesiologists class 3 or above. The sacral ulcer group had the highest incidence of septic shock and bleeding, while the trochanteric ulcer group had the highest incidence of superficial surgical site infection. There was an overall complication rate of 25% at 30-day follow-up. There was no statistical difference in overall complication among groups. Total operating time, diabetes, and non-elective case were independent risk factors for overall complications. Conclusions Despite patients with poor baseline functional status, flap coverage for pressure ulcer patients is safe with acceptable postoperative complications. This type of treatment should be considered for properly selected patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.17 no.2
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• pp.85-92
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• 2014

Recently, the incidence and prevalence of obesity and dyslipidemia are increasing. Dyslipidemia is associated with significant comorbidities and complications, and with cardiovascular risk factors (obesity, diabetes mellitus, hypertension and smoking). The main objectives of this article are that describe the prevalence of dyslipidemia in Korean children and adolescents and review the diagnosis and management of dyslipidemia in children and adolescents.

• Journal of the Korean Society of Food Science and Nutrition
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• v.33 no.8
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• pp.1273-1278
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• 2004

The change of tissue lipid levels and fatty acid compositions in alloxan-induced diabetes was studied in rats (SD, male) in order to examine the pathway of diabetic complications. Rats were injected with alloxan 20 mg/kg BW or 40 mg/kg BW to induce diabetes. In rats injected with alloxan (40 mg/kg BW), the body weight was significantly decreased, food intake and liver weight per 100 g (BW) were significantly increased, compared with other groups. The blood glucose levels were apparently elevated as about 2 times in rats injected with alloxan (40 mg/kg BW) than the other groups. The concentrations of serum total cholesterol, triglyceride and HDL-cholesterol were not significantly different among the groups. However, the levels of serum triglyceride tended to increase according to amount of alloxan injected. Liver cholesterol levels were significantly decreased in rats injected with alloxan (40 mg/kg BW) compared with other groups, but triglyceride levels of those were not significantly different among groups. Concerning the fatty acid compositions of serum, liver, kidney, spleen phosphatidylcholine, the percentage of linoleic acid in rats injected with alloxan (40 mg/kg BW) was significantly increased, while that of arachidonic acid was significantly decreased compared with the other groups. Therefore, the ratios of arachidonic/linoleic acid in tissue phosphatidylcholine tended to be low in rats injected with alloxan (40 mg/kg BW) and especially significant low levels were found in serum and spleen. Thus, it was suggested that insulin deficiency can affect on fatty acid biosynthesis and induce diabetic complications.

• Journal of Pharmaceutical Investigation
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• v.33 no.3
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• pp.171-178
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• 2003

Drug interactions with food, on occasion, lead to serious nutritional and functional changes in the body as well as alterations of pharmacological effect. It, therefore, should be necessary to take drug interactions with food into consideration for effective and safe therapeutics. Diabetes mellitus is a heterogeneous group of disorders characterzed by abnormal glucose homeostasis, resulting in hyperglycemia, and is associated with increased risk of microvascular, macrovascular, and neuropathic complications. However, the precise mechanism of diabetes mellitus remains unclear. Three basic objectives in the care of diabetic patients are maintaining optimal nutrition, avoiding hypo- or hyperglycemia and preventing complications. Laminaria japonica is a brown macroalgae which can be used as a functional diet due to high content of diatery fiber. The purpose of this study was to investigate the effect of Laminaria japonica diet on the pharmacokinetics of metformin which are frequently used in the treatment of diabetes. Diabetic rats induced by streptozotocin were employed in this study. Blood concentrations of oral hypoglycemic agent, metformin, were measured by HPLC and resultant pharmacokinetic parameters were calculated by RSTRIP. The mechanisms of drug interaction with food were evaluated on the basis of pharmacokinetic parameters such as $k_{a},\;t_{1/2},\;C_{max},\;t_{max}$, and AUC. Administration of metformin in normal and diabetic rats treated with Laminaria japonica diet showed significant decrease in AUC, $C_{max},\;and\;k_a$, and increase in $t_{max}$, compared to those with normal diet. This might result from adsortion of metformin on components of Laminaria japonica, causing delayed absorption. The oral glucose test showed that Laminaria japonica diet could lower blood glucose level probably through either inhibiting the activity of disaccharidases, intestinal digestive enzymes, or delaying the absorption of glucose. More studies should be followed to fully understand pharmacokinetic changes of metformin caused by long-term Laminaria japonica diet.

• The Journal of the Korea Contents Association
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• v.18 no.12
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• pp.208-217
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• 2018

The purpose of this study was to provide information on the treatment and management of diabetic patients using all the available data of the Korea National Health and Nutrition Examination Survey (KNHANES, 2013-2015) on the serological and complication patterns of cardiovascular disease (CVD) according to the duration of diabetes mellitus (DM). KNHANES consists of health questionnaires, screenings, and nutrition surveys. The study subjects were 1,316 persons who were aged between 18 and 80 years and who answered the duration of DM. DM was classified as 0-5, 6-10, 11-15, 16-20, and over 20 years according to duration of DM. The longer the duration of DM, the older the BMI, the lower the smoker, the higher the HbA1c and the lower the glomerular filtration rate. Total cholesterol, LDL-C and triglyceride levels were low and HDL-C levels were similar. The proportion of patients receiving insulin and oral hypoglycemic agents increased. The longer the duration of DM, the worse blood glucose control and the increased risk of microvascular and macrovascular complications. To prevent these complications, intensive care and monitoring should be used to control the risk factors.